Exploring Laser Surgery and Alternatives for High Myopia Treatment

Q: Exploring Laser Surgery and Alternatives for High Myopia Treatment

Hello, Miss： When reading, studying, or working on a computer at close distances, our eyes adjust their focus to see nearby objects clearly. <br>This adjustment is achieved through the contraction of small muscles in the eye called the ciliary muscles. <br>Prolonged near work can

Laser surgery

Hello, doctor.
My friend has nearly 1000 degrees of myopia and often experiences eye fatigue and temporary blurred vision due to long hours of work and reading.
The doctor has suggested that he could consider laser surgery to reduce his vision impairment.
I would like to ask if there are other ways to improve his condition besides surgery.
If he opts for surgery, what should he pay attention to and evaluate? Thank you!

Rìguāng, 30~39 year old female. Ask Date: 2007/10/18

Dr. Liu Jingxian reply Ophthalmology

Hello, Miss: When reading, studying, or working on a computer at close distances, our eyes adjust their focus to see nearby objects clearly.
This adjustment is achieved through the contraction of small muscles in the eye called the ciliary muscles.
Prolonged near work can lead to fatigue of the ciliary muscles, which may even result in temporary blurred vision.
Taking appropriate breaks allows the ciliary muscles to relax; closing your eyes for rest is one method.
Looking into the distance can also help relax the ciliary muscles.
Additionally, applying warm compresses in the morning and evening can be beneficial.
It is important to practice good eye care habits, avoiding excessive eye strain and fatigue, as this is the key to eye health.
Therefore, high myopia cannot be directly equated with eye fatigue; rather, the habits of using the eyes are the main contributing factors to eye fatigue.
Furthermore, after the age of 40, the phenomenon of eye fatigue becomes more pronounced, which is a normal age-related change known as presbyopia.
Before considering laser surgery, it is advisable to undergo a more detailed evaluation and consultation to minimize misunderstandings.
Additionally, patients with high myopia should have regular eye health check-ups and dilated retinal examinations, as literature indicates that they have a higher risk of developing cataracts, glaucoma, and retinal tears (retinal detachment).
Wishing you good health.
Dr.
Liu Jing-Hsi, Ophthalmology, Taipei City Hospital, Zhongxing Branch, Taiwan e-Learning Academy.

Reply Date: 2007/10/18

More Info

High myopia, or severe nearsightedness, is a condition where the eye is elongated, causing distant objects to appear blurry. With a prescription nearing -10.00 diopters, your friend is at a significant risk for various complications, including retinal detachment, glaucoma, and cataracts. Laser surgery, specifically procedures like LASIK (Laser-Assisted In Situ Keratomileusis) or PRK (Photorefractive Keratectomy), can be effective options for correcting high myopia, but there are also alternative methods and considerations to keep in mind.

Alternatives to Laser Surgery
1. Contact Lenses and Glasses: The most common non-surgical approach to managing high myopia is through corrective lenses. High-index lenses can reduce the thickness and weight of glasses, making them more comfortable. Contact lenses, including rigid gas permeable (RGP) lenses or soft lenses, can also provide a wider field of vision and may be more comfortable for prolonged use.

2. Orthokeratology (Ortho-K): This is a non-surgical method where specially designed contact lenses are worn overnight to temporarily reshape the cornea. This can provide clear vision during the day without the need for glasses or contact lenses. However, the effects are temporary and require ongoing use of the lenses.

3. Phakic Intraocular Lenses (IOLs): For individuals with high myopia who may not be suitable candidates for laser surgery, phakic IOLs can be implanted in the eye without removing the natural lens. This procedure can provide significant vision correction.

4. Vision Therapy: While not a direct treatment for high myopia, vision therapy can help improve visual skills and reduce eye strain, especially for individuals who spend long hours reading or using screens.

5. Lifestyle Modifications: Encouraging your friend to take regular breaks while working or reading (the 20-20-20 rule: every 20 minutes, look at something 20 feet away for 20 seconds) can help reduce eye strain. Additionally, ensuring proper lighting and ergonomics while working can also alleviate discomfort.

Considerations for Laser Surgery
If your friend decides to pursue laser surgery, several factors should be evaluated:
1. Comprehensive Eye Examination: A thorough eye exam is essential to assess the overall health of the eyes, including the cornea's thickness, the degree of myopia, and the presence of any other eye conditions.

2. Age and Stability of Prescription: Candidates should typically be over 18 years old, and their prescription should be stable for at least a year. Significant changes in vision can affect the outcome of the surgery.

3. Corneal Thickness: Laser procedures reshape the cornea, so sufficient corneal thickness is necessary to avoid complications post-surgery.

4. Potential Risks and Side Effects: While laser surgery is generally safe, there are risks involved, including dry eyes, glare, halos, and in rare cases, vision loss. Discussing these risks with an ophthalmologist is crucial.

5. Post-operative Care: Following the procedure, patients must adhere to post-operative care instructions, including using prescribed eye drops and attending follow-up appointments to monitor healing.

6. Expectations: It's important for your friend to have realistic expectations regarding the outcomes of the surgery. While many achieve 20/25 vision or better, some may still require glasses for certain activities.

In conclusion, while laser surgery can be a viable option for correcting high myopia, there are several alternatives and considerations to explore. It is essential for your friend to consult with an experienced ophthalmologist who can provide personalized recommendations based on their specific condition and lifestyle.

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